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Is it normal to have severe pain after surgery for lisfranc injury and broken metatarsals?

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Orthopaedic Surgeon
Practicing since : 1998
Answered : 4917 Questions
I recently had surgery for a lisfranc injury and broken metatarsals, nos 2 and 3 communited and avulsion to no 4 plus cuneiform. I am 8 weeks post surgery. I have multiple screws and a plate on mets 1, 2 and 3 to stabilise. I was given the ok to start weight bearing ie walking on Christmas day. However upon trying to walk I found I have extreme pain on the outside of my 5th metatarsal head if and when i weight bear. This bone was not injured originally. Is this normal ? The whole area is still relatively swollen and tight and I'm not expecting miracles but I am worried about the level of pain as it may be indicating a serious problem ie stress fracture? My dr is on holidays and I wonder if I should stay off it until I can see him or is this type of pain in this area is not abnormal and I just need to do a bit each day and it will slowly improve. I am trying my walking in bare feet on timber floors as I have yet to get some suitable footwear. Im only doing like 10 steps. My dr said a cam boot wasn't needed. My broken bones are healing well and in correct position according to recent x rays. Some advice or reassurance would be appreciated.
Posted Sun, 12 Jan 2014 in Bones, Muscles and Joints
Answered by Dr. Vaibhav Gandhi 2 hours later
Brief Answer: Do not worry its not serious problem. Detailed Answer: Hello, Thanks for writing to us, I have studied your case with diligence. Pain 8 weeks after injury is not normal but it can be due to weight bearing during first 2 to 3 days. In lisfranc injury there is instability of midfoot and forefoot so even if you have not injured your 5 th metatarsal there can be pain there due to altered anatomy. Another reason of pain can be due to multiple screw and plate causing impaction. And pain also can be due to stress fracture if you injured again. Do not worry its not serious problem; just consult your doctor when he comes back. Till time take medication like analgesic and apply crepe bandage over foot or use supportive splint. Physiotherapy will help to reduce swelling over foot. Some nutrients which are important for recovery after surgery include vitamin C, folic acid, calcium, vitamin D, VIT supplements of these nutrients will lead to early recovery. Regular physiotherapy and exercises are very important for early rehabilitation as my patients find much relief by these therapies. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you are satisfied with the answer, please give your review at the end of the discussion. Wishing you good health. Take care.
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